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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2017 | Original research

Routine blood tests are associated with short term mortality and can improve emergency department triage: a cohort study of >12,000 patients

Authors: Michael Kristensen, Anne Kristine Servais Iversen, Thomas Alexander Gerds, Rebecca Østervig, Jakob Danker Linnet, Charlotte Barfod, Kai Henrik Wiborg Lange, György Sölétormos, Jakob Lundager Forberg, Jesper Eugen-Olsen, Lars Simon Rasmussen, Morten Schou, Lars Køber, Kasper Iversen

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2017

Abstract

Background

Prioritization of acutely ill patients in the Emergency Department remains a challenge. We aimed to evaluate whether routine blood tests can predict mortality in unselected patients in an emergency department and to compare risk prediction with a formalized triage algorithm.

Methods

A prospective observational cohort study of 12,661 consecutive admissions to the Emergency Department of Nordsjælland University Hospital during two separate periods in 2010 (primary cohort, n = 6279) and 2013 (validation cohort, n = 6383). Patients were triaged in five categories by a formalized triage algorithm. All patients with a full routine biochemical screening (albumin, creatinine, c-reactive protein, haemoglobin, lactate dehydrogenase, leukocyte count, potassium, and sodium) taken at triage were included. Information about vital status was collected from the Danish Central Office of Civil registration.

Multiple logistic regressions were used to predict 30-day mortality. Validation was performed by applying the regression models on the 2013 validation cohort.

Results

Thirty-day mortality was 5.3%. The routine blood tests had a significantly stronger discriminative value on 30-day mortality compared to the formalized triage (AUC 88.1 [85.7;90.5] vs. 63.4 [59.1;67.5], p < 0.01). Risk stratification by routine blood tests was able to identify a larger number of low risk patients (n = 2100, 30-day mortality 0.1% [95% CI 0.0;0.3%]) compared to formalized triage (n = 1591, 2.8% [95% CI 2.0;3.6%]), p < 0.01.

Conclusions

Routine blood tests were strongly associated with 30-day mortality in acutely ill patients and discriminatory ability was significantly higher than with a formalized triage algorithm. Thus routine blood tests allowed an improved risk stratification of patients presenting in an emergency department.

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Title: Routine blood tests are associated with short term mortality and can improve emergency department triage: a cohort study of >12,000 patients
Authors: Michael Kristensen
Anne Kristine Servais Iversen
Thomas Alexander Gerds
Rebecca Østervig
Jakob Danker Linnet
Charlotte Barfod
Kai Henrik Wiborg Lange
György Sölétormos
Jakob Lundager Forberg
Jesper Eugen-Olsen
Lars Simon Rasmussen
Morten Schou
Lars Køber
Kasper Iversen
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2017
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/s13049-017-0458-x

Keynote webinar | Spotlight on sleep in brain health

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Routine blood tests are associated with short term mortality and can improve emergency department triage: a cohort study of >12,000 patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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